Of all the lasting images from the 2014 World Cup, the officials who run FIFA, soccer’s governing body, should be forced to remember one, above all: Germany’s Christoph Kramer staggering around the field in the final, glassy-eyed and dazed, like a sleepwalker.

It was a glaring symbol of FIFA’s misguided approach to concussions and how desperately it needs to amend its substitution rules, which now allow for only three replacements per game and dictate that once a player is out of the game, he stays out. Faced with those restrictions, coaches are hesitant to keep a player with a possible head injury from leaving the match. Nor are they motivated to allow enough time for that player to get a proper medical checkup, because it means playing a man short while the examination takes place.

That’s right, in soccer, as in many professional sports, winning trumps common sense and, for that matter, basic humanity.

Early in last Sunday’s World Cup final, Kramer, 23, had sustained an apparent concussion when his head slammed into an opposing player from Argentina. Yet Kramer returned to play moments later and stayed in the game for 14 more minutes before falling to the ground and being escorted off. Later, he said he couldn’t remember much of what occurred while he was on the field.

About 4,800 miles away, in New York City, a former United States soccer star, Alecko Eskandarian, had seen Kramer’s injury and quick return to the match and said, “My God, this is crazy.”

Eskandarian, Major League Soccer’s No. 1 draft pick in 2003 and a former collegiate player of the year, had no choice but to walk away from professional soccer because of the effects of a series of concussions. Five years after retiring, he said, he still struggles with headaches, concentration, sensitivity to light and vertigo.

He said his first of several documented concussions occurred when he played for D.C. United in his first M.L.S. season. After colliding with another player, he landed on his head. Everything went black. Upon waking, trainers kept the evaluation simple, Eskandarian said.

They said: Where are you? Then, something to the effect of: You good to go? In his cloud of consciousness, he said, he remembered saying, “Yep, feeling good.”

Eskandarian kept playing. He can barely stand to watch a video of that game because he sees himself running around aimlessly, even though he almost scored a goal.

“It was like an airplane on cruise-control — the plane is flying, but the pilot’s not there,” he said. “Knowing what I know now, I was very fortunate not to get hit again. As a player, you put your trust in the doctors and trainers to evaluate you and take care of you. In that way, they really let me down.”

In essence, Eskandarian was a valuable player, the team wanted him to play and the coach didn’t want to waste a substitution by taking him out. And if he left the field to be properly evaluated, he couldn’t go back into the game unless the coach was willing to play 10 against 11 indefinitely.

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Alecko Eskandarian, right, playing for Chivas USA in 2008 against Colorado’s Ugo Ihemelu. He is now coaching.CreditVictor Decolongon/Getty Images

Instead, Eskandarian’s safety was put at risk. And that same thing is still happening everywhere in the sport, even at its highest level, as demonstrated in recent weeks in the World Cup.

Eskandarian, now an assistant coach for the New York Cosmos in the North American Soccer League, laughed when asked about FIFA changing its substitution rule to give doctors enough time to properly evaluate players for concussions.

For instance, when a player with a head injury is being checked — a process that requires at least 10 minutes, some concussion experts say — teams could use a temporary substitute. Then, if the injured player is cleared to play, he could re-enter the game. And the team would not be charged with one of its three official substitutions.

“You’re going to have players faking head injuries left and right,” said Eskandarian, whose father, Andranik, played for the Cosmos decades ago and for Iran’s national team in the 1978 World Cup. “Suddenly, if one team has momentum, 10 guys from the other team would have concussions. It’s a slippery slope and it will ruin the game. So I’m not sure you can ever change that rule.”

In a game already tarnished by diving and other theatrics, Eskandarian has a point.

But there should be room for amending soccer’s substitution rule, if only to save players from suffering a life of post-concussion syndrome similar to Eskandarian’s. Players need to understand that the amended rule would be designed to save lives, including, perhaps, their own.

Chris Nowinski, the executive director of the Sports Legacy Institute and a supporter of head-trauma research in sports, said the way to keep players from faking head injuries would be to educate them about the seriousness of concussions.

“Then players would be more willing to be on their honor and report a head injury if they think they have one,” he said. “They have to be willing to change the culture of the game.”

Dr. Robert Cantu, a leading expert in sports-related concussions, said there ideally should be no time limit for a doctor to evaluate a player for a head injury.

He encouraged FIFA to start changing its policies, even if it takes baby steps by starting with a mandatory 10-minute assessment of a player. Considering that FIFA is already way behind many other top sports entities, like the N.F.L., or international rugby, in the way it treats concussions, any improvement would be a big improvement, he said.

“FIFA has had the eyes of the world look at them and has rather unanimous criticism from concussion specialists in this country, who were kind of appalled at the way they handled concussions,” he said. “I do think it’s time for them to change.”

If FIFA had better rules when Eskandarian was playing, he might not have had to retire in his mid-20s and he might not be suffering the way he is now, at age 32. Years removed from his playing days, he said he gets headaches if he raises his heart rate too high or if he tries to concentrate for too long, especially while on the computer. He gets nauseated riding in the back seat of a car. Sometimes, he said, he even gets headaches if he laughs too hard.

“I think about concussions every day because they have affected my life and completely changed my life, so I’m forced to think about it,” he said.